No abstract available.
Humans ; Infant*

The ovarian dermoid cyst is the most common ovarian neoplasm in young women and comprises approximately 10-20% of all ovarian tumors. But malignant transformation is an uncommon complication in an ovarian dermoid cyst, usually being reported in about 1.0-1.8% of cases. Most common malignant transformation of ovarian dermoid cyst is squamous cell carcinoma, which represents about 75-80% followed by adenocarcinoma in 6-7%. We report a case of adenocarcinoma arising from ovarian dermoid cyst with a brief review of literatures.
Adenocarcinoma* ; Carcinoma, Squamous Cell ; Dermoid Cyst* ; Female ; Humans ; Ovarian Neoplasms ; Ovary*

PURPOSE: To compare the MR findings of a sequestered disc with an extruded disc. MATERIALS AND METHODS: MR images of 28 patients with a sequestered disc and 18 patients with an extruded disc were retrospectively reviewed. Patients with sequestered discs were divided into two groups whether definite separation from the parent disc was or was not seen. In the latter group (definite separation not seen) and the extruded disc group of patients, the signal intensities of the herniated discs were compared with the signal intensities of the parent discs and were evaluated on T1- and T2-weighted images. We also assessed the presence of a notch within the herniated disc. RESULTS: In the sequestered disc group of patients (28 discs), only 5 discs (18%) showed obvious separation from the parent disc. Among the remaining 23 discs with indefinite separation, the notch was visible in 14 discs (61%) and 9 discs (39%) had no notch. In the extruded disc group (18 discs), the notch was visible in 2 (11%) discs and the difference between the two groups was statistically significant (p = 0.0002). The signal intensities of the herniated discs on T1-weighted images were isointense in both the sequestered and extruded discs. The difference of incidence of high signal intensities on T2-weighted images was not statistically significant (p = 0.125). CONCLUSION: It is necessary to consider the possibility of the presence of a sequestered disc when a herniated disc material shows a notch.
Humans ; Incidence ; Intervertebral Disc Displacement ; Magnetic Resonance Imaging* ; Parents ; Retrospective Studies ; Spine*

PURPOSE: This study was done to identify the relationship of malnutrition, social network and health-related quality of life and to investigate the main factors influencing health-related quality of life in elders. METHODS: The research design was a descriptive survey design using a convenience sampling. Data were collected by self-report questionnaires from 196 elders. Data analysis was done using SPSS 18.0 pc+ program for descriptive statistics, Pearson correlation coefficients and stepwise multiple regression. RESULTS: The average score for health related quality of life was 3.33 (SD=0.86). Differences in health-related quality of life were statistically significant according to age, gender, occupation, presence of spouse, monthly income, source of income, economic status, medicine, and existence of chronic disease. Health-related quality of life was significantly correlated with malnutrition and social network. Major factors affecting health related quality of life for elders were malnutrition, occupation, age, social network, and economic status which explained 52.0% of the variance in health related quality of life. CONCLUSION: Findings provide a basis for developing nursing interventions to improve health-related quality of life. Future studies are needed a wide variety of variables that might influence health-related quality of life in elders.
Aged ; Chronic Disease ; Humans ; Malnutrition ; Occupations ; Quality of Life ; Surveys and Questionnaires ; Research Design ; Spouses ; Statistics as Topic

PURPOSE: Pain is the most common and influential symptom in cancer patients. Few studies concerning pain intensity in the terminally ill cancer patients have been done. This study aimed to identify factors related with more than moderate pain. METHODS: This study used secondary data of 162 terminal cancer inpatients at the palliative ward of six training hospitals in Korea. Physician-assessed pain assessment was by 10 point numeric rating scale. Substantial pain was defined more than moderate intensity by the Korean National Guideline for cancer pain. The Korean version of the MD Anderson Symptom Inventory was self-administered to assess symptoms. Survival prediction was estimated by the attending physicians at the time of admission. RESULTS: Less than six weeks of predicted survival and more than numeric rating of six for worst drowsiness in the previous 24 h were significantly related to substantial pain (P=0.012 and P=0.046, respectively). The dose of opioid analgesics was positively related to substantial pain (P=0.004). CONCLUSION: Factors positively related to substantial pain were less than six weeks of predicted survival and considerable drowsiness. Careful monitoring and active preparation for pain are required in terminal cancer patients having those factors.
Analgesics, Opioid ; Humans ; Inpatients ; Korea ; Pain Measurement ; Sleep Stages ; Terminally Ill

BACKGROUND: Few studies have been done regarding the level of DHEA which is influenced by age, and their effect on cardiovascular disease and prevention of cancer. It is a well known fact that the level of DHEA is decreased with age and the aging is not a correctable risk factor for cardiovascular disease. The aim of this study was to identify plasma DHEA-S change by age and to find out if there was any correlation with serum DHEA-S and cardiovascular risk factors. METHODS: The author collected blood from 85 males and 80 females who had no particular disease history and no specific findings on physical examination. If there were any changes of DHEA according to age, we analyzed the correlation of DHEA with cardiovascular risk factors such as blood pressure, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein and obesity index (body mass index, waist/hip ratio). RESULTS: In both males and females, plasma DHEA-S level peaked at third dacades and the concentration of DHEA was significantly decreased according to aging (p<0.01). In males, DHEA-S showed no correlations with cardiovascular risk factors. In females, DHEA-S showed negative correlations with systolic blood pressure, diastolic blood pressure, total cholesterol, and low density lipoprotein. Also, high density lipoprotein positively correlated with DHEA-S. These correlations in female subjects, however, disappeared after multiple regression analysis. CONCLUSION: In both males and females, plasma DHEA-S was significantly decreased with advancing age. There was no significant correlation between DHEA-S and cardiovascular risk factors in both men and women.
Aging ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Dehydroepiandrosterone* ; Female ; Humans ; Lipoproteins ; Male ; Obesity ; Physical Examination ; Plasma* ; Risk Factors* ; Triglycerides

Kartagener's syndrome (KGS) is an autosomal recessive disorder which possible to link the occurrence of abnormal ciliary movement and abnormal position of the body organs. Considering the fact that airway ciliary function plays an important role in the primary pulmonary defense mechanism, prevent the ciliodepressant actions are also important for anesthetic management. We described successful anesthetic management of a 44-year-old male scheduled for endoscopic sinus surgery who had a history of frequent epistaxis, anosmia and situs inversus totalis. Anesthesia was induced and maintained with propofol and remifentanil using a target controlled infusion device.
Adult ; Aluminum Hydroxide ; Anesthesia ; Anesthesia, Intravenous ; Carbonates ; Epistaxis ; Humans ; Kartagener Syndrome ; Male ; Olfaction Disorders ; Piperidines ; Propofol ; Situs Inversus

BACKGROUND: Patients diagnosed as an advanced cancer and families need accurate information about the length of survival in order to plan for and to make the best use of the time that remains. The health care of that patient can then be redirected toward palliation and mobilizing resources to ensure a comfortable life. The purposes of this study were to evaluate the prognostic value of performance status plus some physical symptoms and some biological indices and there fore to assist in planning appropriate palliative care. METHODS: This study was performed on 161 patients, who had been diagnosed as advanced cancer in Korea University Guro Hospital from July 1999 to July 2000. : We requested Karnofsky performance status scale, mental status, jaundice, severity of pain, anorexia, voiding difficulty, dyspnea and dry mouth We assessed the biological indices by leukocyte count, plasma albumin, proteinuria. RESULTS: We could confirm 82 patients' death(54.37) of 151 patients. Univariate analysis showed that Karnofsky performance status scale, mental status, jaundice, severity of pain, anorexia, voiding difficulty, dyspnea, dry mouth, leukocyte count, albumin and proteinuria demonstrated a statistically significant predictive prognosis. Multivariate analysis using Cox's proportional hazard model showed that age, performance status, albumin, proteinuria were independent predictors of survival and severity of pain had the borderline value. CONCLUSION: Age, performance status, albumin and proteinuria were the independent prognostic factors for patients with advanced cancer.
Anorexia ; Delivery of Health Care ; Dyspnea ; Humans ; Jaundice ; Karnofsky Performance Status ; Korea ; Leukocyte Count ; Mouth ; Multivariate Analysis ; Palliative Care ; Prognosis ; Proportional Hazards Models ; Proteinuria ; Serum Albumin

BACKGROUND: A predominant accumulation of adipose tissue in abdominal region confers increased risk of cardiovascular disease. The best technology available for measurement of regional fat distribution is computed tomography. However, computed tomography is limited its use for clinical purposes by cost. The aim of this study is to identify the best simple anthropometric index of abdominal visceral fat accumulation. METHODS: To quantify the relationship between anthropometric indices of abdominal obesity(waist circumference, waist to hip ratio, waist to height ratio, body mass index, abdominal sagittal diameter) and abdominal(total, visceral, subcutaneous) fat areas measured by computed tomography, correlation and multiple regression analyses have been conducted. RESULTS: No significant difference for waist circumference, body mass index and sagittal diameter between men and women have been found. Mean value of waist to hip ratio is larger in women, but waist to height ratio is larger in men. The mean abdominal total fat area and mean subcutaneous fat area are higher in women. Interestingly, men, despite lower total fat area, have higher mean abdominal visceral area. Thus, the mean visceral fat to subcutaneous fat ratio is much higher in men. Abdominal sagittal diameter shows the highest correlation(men: 0.69, women: 0.76) with abdominal visceral fat area in both genders. Stepwise regression analyses have been performed to determine the best simple anthropometric index of abdominal visceral fat accumulation. In men, the significant indices are abdominal sagittal diameter, body mass index, and waist to height ratio. In women, abdominal sagittal diameter is the only significant index. CONCLUSION: Abdominal sagittal diameter, in comparison with the waist circumference, waist to hip ratio, waist to height ratio and body mass index, is the best predictor of the amount of abdominal visceral fat.
Adipose Tissue ; Body Mass Index ; Cardiovascular Diseases ; Female ; Hip ; Humans ; Intra-Abdominal Fat* ; Male ; Obesity ; Subcutaneous Fat ; Waist Circumference ; Waist-Hip Ratio

BACKGROUND: Although medical students' clinical competence should be assessed systematically and objectively, written exams or faculty's subjective methods were used in the past. We assessed the clinical competence of the family medicine clerkship students using the OSCE and evaluated the reliability and the validity of the OSCE. The purpose of this study was to find the logistic problems and the feasibility of the OSCE to an entire clerkship evaluation. METHODS: Twenty six volunteers took part in the OSCE. Ten, 5-minute long stations, were divided into 4 areas: 3 for history taking, 3 for physical exam, 3 for technical skill, and 1 for interview skill areas. RESULTS: Eleven students were examined on first session and 15 students on second session 4 weeks later. The mean OSCE score was 65.5 5.63. The reliability of the total stations was 0.615. The total OSCE score was not different by the sessions, but there was a significant difference in the two stations where the examiners had been changed. There were statistically significant correlations between the total OSCE score and the two previous written exams (r=0.56, 0.54, P<0.01). There was no significant logistic problem and the examinees showed positive responses to the OSCE. CONCLUSION: The OSCE was a useful tool for assessing the clinical competence of family medicine clerkship students. The reliability of the OSCE was moderate and in order to extend the OSCE to an entire clerkship evaluation, we need further study to acquire a higher reliability and validity.
Clinical Competence* ; Humans ; Reproducibility of Results ; Volunteers